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Bioabsorbable fixation device enables minimally invasive browpexy

Article-Bioabsorbable fixation device enables minimally invasive browpexy

Key iconKey Points

  • Procedure performed through small upper blepharoplasty incision
  • There is a learning curve with the technique
  • Device should maintain position when correctly placed

Dr. Thomas
Nonendoscopic, transblepharoplasty brow suspension using a bioabsorbable fixation device (Endotine TransBleph, Coapt Systems) provides safe, reliable and stable results for patients interested in minimally invasive forehead rejuvenation, according to Mohan Thomas, M.D., D.D.S.

The procedure is performed through a small upper blepharoplasty incision. After subperiosteal dissection, the device is fixed within the frontal bone just above the supraorbital rim. Subcutaneous tissue beneath the lateral brow is engaged onto the device's hooks to achieve secure and even suspension.

Dr. Thomas' experience using the bioabsorbable fixation device includes a series of 50 patients, and he reports they were universally satisfied with the aesthetic results. The average brow elevation achieved was 2.2 mm, the benefit was maintained in follow-up ranging from 8 to 15 months and there were few minor complications such as bruising and swelling for more than 10 days.

"There are multiple techniques for browlifting and forehead rejuvenation, and all can claim good results with minimal complications," says Dr. Thomas, a cosmetic surgeon in private practice in Mumbai, India. "However, traditional and subcutaneous lifts result in long scars, while endoscopic procedures involve a learning curve and require special equipment."

A 45-year-old patient, concerned with "tired-looking" eyes, before (left) and one year after Endotine browlift and upper blepharoplasty.
"The latter drawbacks are avoided in browlifting with this bioabsorbable fixation device, and the procedure is also relatively easy to learn and allows for good intraoperative control of brow position," he says. "However, it is not a panacea or the end-all procedure. There is an added cost for using the device, a small learning curve with a chance of causing injury to the supraorbital nerve for first-time users, and compared with my own percutaneous suture suspension browlift, the surgical time is longer."

The patients in Dr. Thomas's series ranged in age from 26 to 65 years and included 16 males. Complications encountered included implant palpability in five patients. The affected individuals had very thin tissue overlying the implant and the palpability resolved within four to six months as the device was absorbed.

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